Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis
Abstract Background Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explore...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-017-0739-7 |
| _version_ | 1819149371418083328 |
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| author | Karla Gonzalez Jesus G. Ulloa Gerardo Moreno Oscar Echeverría Keith Norris Efrain Talamantes |
| author_facet | Karla Gonzalez Jesus G. Ulloa Gerardo Moreno Oscar Echeverría Keith Norris Efrain Talamantes |
| author_sort | Karla Gonzalez |
| collection | DOAJ |
| description | Abstract Background Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explores intensive procedure preferences at the EOL in older Latino adults. Methods Seventy-three community-dwelling Spanish- and English-Speaking Latinos over the age of 60 with and without ESRD participated in this study. Those without ESRD (n = 47) participated in one of five focus group sessions, and those with ESRD on dialysis (n = 26) participated in one-on-one semi-structured interviews. Focus group and individual participants answered questions regarding intensive procedures at the EOL. Recurring themes were identified using standard qualitative content-analysis methods. Participants also completed a brief survey that included demographics, language preference, health insurance coverage, co-morbidities, Emergency Department visits and functional limitations. Results The majority of participants were of Mexican origin with mean age of 70, and there were more female participants in the non-ESRD group, compared to the ESRD dialysis dependent group. The dialysis group reported a higher number of co-morbidities and functional limitations. Nearly 69% of those in the dialysis group reported one or more emergency department visits in the past year, compared to 38% in the non-ESRD group. Primary themes centered on 1) The acceptability of a “natural” versus “invasive” procedure 2) Cultural traditions and family involvement 3) Level of trust in physicians and autonomy in decision-making. Conclusion Our results highlight the need for improved patient- and family-centered approaches to better understand intensive procedure preferences at the EOL in this underserved population of older adults. |
| first_indexed | 2024-12-22T14:00:33Z |
| format | Article |
| id | doaj.art-e294689809884680ad4f6de199a2eea7 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-22T14:00:33Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-e294689809884680ad4f6de199a2eea72022-12-21T18:23:26ZengBMCBMC Nephrology1471-23692017-10-011811910.1186/s12882-017-0739-7Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysisKarla Gonzalez0Jesus G. Ulloa1Gerardo Moreno2Oscar Echeverría3Keith Norris4Efrain Talamantes5Department of Family Medicine, David Geffen School of Medicine at University of California, Los AngelesDepartment of Surgery, University of California San FranciscoDepartment of Family Medicine, David Geffen School of Medicine at University of California, Los AngelesUCLA David Geffen School of Medicine at University of CaliforniaRobert Wood Johnson Foundation, Clinical Scholars Program, University of California, Los AngelesDivision of General Internal Medicine, University of California, Davis School of MedicineAbstract Background Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explores intensive procedure preferences at the EOL in older Latino adults. Methods Seventy-three community-dwelling Spanish- and English-Speaking Latinos over the age of 60 with and without ESRD participated in this study. Those without ESRD (n = 47) participated in one of five focus group sessions, and those with ESRD on dialysis (n = 26) participated in one-on-one semi-structured interviews. Focus group and individual participants answered questions regarding intensive procedures at the EOL. Recurring themes were identified using standard qualitative content-analysis methods. Participants also completed a brief survey that included demographics, language preference, health insurance coverage, co-morbidities, Emergency Department visits and functional limitations. Results The majority of participants were of Mexican origin with mean age of 70, and there were more female participants in the non-ESRD group, compared to the ESRD dialysis dependent group. The dialysis group reported a higher number of co-morbidities and functional limitations. Nearly 69% of those in the dialysis group reported one or more emergency department visits in the past year, compared to 38% in the non-ESRD group. Primary themes centered on 1) The acceptability of a “natural” versus “invasive” procedure 2) Cultural traditions and family involvement 3) Level of trust in physicians and autonomy in decision-making. Conclusion Our results highlight the need for improved patient- and family-centered approaches to better understand intensive procedure preferences at the EOL in this underserved population of older adults.http://link.springer.com/article/10.1186/s12882-017-0739-7Renal diseaseLatinosEnd of lifeAdvanced care planningDialysisIntensive procedures |
| spellingShingle | Karla Gonzalez Jesus G. Ulloa Gerardo Moreno Oscar Echeverría Keith Norris Efrain Talamantes Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis BMC Nephrology Renal disease Latinos End of life Advanced care planning Dialysis Intensive procedures |
| title | Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis |
| title_full | Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis |
| title_fullStr | Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis |
| title_full_unstemmed | Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis |
| title_short | Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis |
| title_sort | intensive procedure preferences at the end of life eol in older latino adults with end stage renal disease esrd on dialysis |
| topic | Renal disease Latinos End of life Advanced care planning Dialysis Intensive procedures |
| url | http://link.springer.com/article/10.1186/s12882-017-0739-7 |
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